HomeMy WebLinkAboutDriveway Street Cut Permits 83 Pine Knob TOWN OF SOUTH WINDSOR INSPECTION REPORT
termit No. 4301 Contractor BOUTtN SONS
Locations
.. 7E Af3dres ,121 NDSOR�VILLE ROAD
Type Work DRIVEWAY A,;ROAD B'RO.:pr T 'Q,6016
F�hone°' To Mft:916:3.34..2526
Date Insp Needed U
----------- W
W
Time Insp Needed
Inspected By — �WorkiD
in Progress
-------
b
Permit No. 4301 Town of South Windsor, CT
Date 09/27/2006 Street Excavation Permit
Expiration Date 09/27/2007
Descrip:
Applicant LGcaraon
Name BOUTIN & SONS (o633 "FN I�B:`DiTV '
Addr. 121 WINDSORVILLE ROAD .
BROAD BROOK CT 0604¢ e Work DtIVDytnlAY
Phone (860)623-2526
Applicant agrees CG..<fuzfiSh'the. TESwp, o SG��xth Windsor tfie amount of bond
required and to reimburse Y,}y� :town pP Zomth C n lsor fq 'any expetises
incurred by the Town fo:r ma�� enar� rye r �ai T. mn eoianection with this
permit and that appl,iant to €amilxar w'iC`t and itxTlls�de hy the rules and
regulations for permits "as bu ,lane ,'Stt � �sus sit. Sgtity2 Wnc#sor's Street
Cut Permit Manual.
PERMIT 'T'q BwICEP'I
Issued by —_-- —_ Title
Date Completedcted By
APPLICATION FOR STREET EXCAVATION PERMIT
_ TOWN OF SOUTH WINDSOR
PUBLIC- WORKS DEPARTMENT
I, Q
OWN HALL
1540 SULLIVAN. AVENUE
SOUTH WINDSOR, CT
FEE 25.00
Name of Firm Boutin & Sons Cons t. Co . Phone No. 623-2526
Address of Firm 121 Winds orvi 1-1-e--R-o-a-T Broadrook, Conn
Location of proposed work_ $3 P i n e Kn n_ Drive
y
Describe fully nature of permit requested_ Complete dig 6uiuby garage, stripping, area by road,
add process gravel, grade, roll and pave
Starting date Approx.time for completion
Call before you dig no. 20063802027 Traffic Services Control No.
Show sketch of proposed work or furnish To be fiIied out by Town of So Windsor
two copies of separate drawing Pavement Cut
Indicate North Prop.size of cut
No.cuts
Amt.of Deposit S by
O Cash(J Check#
Cut size after Perm. Patch
No.Cuts
Final Billing S
Amt. Due Payee S
Amt.Due Town S
Applicant is responsible for contacting
the Police Dept. and C.S.Y.D.
by. date,
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE TOWN OF
SOUTH WJNDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS
PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE
TOWN OF SOUTH WINDSOR's STREET CUT PERMIT MANUAL.
Signed; Da
te•
Title: L.5
D.L.#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
Job Location: co_
Description: ._
Quote Good for96Days. • '
Special Attention: 1/2 Payment Upon Starting, Balance Upon Completion.
Contract cA Permit
ONE YEAR GUARANTEE ON WORKMANSHIP &MATERIALS. Pres.
CBUD ��? � � � / Date °.S_ e),